Womb to Bloom - Maternity & Beyond

At about 28 weeks along during my pregnancy with twins, my obstetrician said that she wanted me to have fetal non-stress tests (NSTs) on Mondays and Thursdays. “Every week?!,” I asked. “Every week, twice a week for the next 10 to 12 weeks” was the answer.

When my NSTs were ordered, I really had no idea what they were or what they were for. I quickly learned that I had nothing to worry about. They actually put my mind at ease most of the time. Fetal non-stress tests are generally performed during the third trimester of a woman’s pregnancy, often just during the very last few weeks. The test involves two monitors strapped across the mother’s belly – one to record contractions and one to record the fetal heart rate.

(Sneak preview of labor and delivery: you get the same monitors at the hospital when you go into labor.) You will lie down on your left side, usually with a pillow or wedge at your back. The non-stress test generally lasts about a half an hour while the nurse looks for fetal movement and a strong and reactive fetal heart rate.

You can close your eyes and rest or read a magazine. I usually just chatted with my nurse and watched the monitors. And enjoyed the peace and quiet, far away from my 3 and 4 year olds. When you’ve got other kids at home, an NST can be strangely like a spa experience – a half hour of relaxation, the only sound you hear is the soft swish-swish-swish of the fetal heart monitor…but I digress.

We were talking about NSTs. The nurse is looking for baby’s heart rate increases (called “accelerations”) and decreases. If your baby is snoozing during the test, the nurse may use a buzzer to wake the baby up. I remember tapping lightly on my abdomen or nudging a little butt or head to get one of my babies to wake up during almost every test. (I know that sounds so weird, especially if you’ve never been pregnant before. But it’s true, there’s a real live baby in there and she’s got parts and she sleeps too!)

My nurse also encouraged me to eat a good breakfast just before my monitoring to try to keep those babies perky. Sometimes, I even ran through the Starbucks drive-thru on the way – the babies were definitely awake and active on those mornings! (I know, I know – studies, caffeine, pregnancy…don’t judge.)

NSTs are generally ordered in high risk pregnancies (including multiples, diabetes or high blood pressure), when there has been decreased fetal movement, when there has been some suggestion that your placenta is problematic or if you are overdue. It can indicate whether your baby is not receiving enough oxygen due to umbilical or placental problems or whether there is some other fetal distress.

If your baby is not getting enough oxygen, he will not have appropriately reactive heart rates during these NSTs. If an NST indicates that the heart rate is nonreactive (not enough accelerations and decelerations), you will be sent for further monitoring or testing.

On one occasion during my twin pregnancy, I was sent to the hospital for further monitoring because one of my babies’ heart rate did not appropriately accelerate during my NST. It was pretty nerve-wracking to drive from the doctor’s office to the hospital, where I checked in for an hour’s worth of monitoring. All was well, “baby B” had just been sleeping and had apparently not liked my position at the doctor’s office. He performed just fine at the hospital and I was glad that my little guys were being looked after so well.

NSTs must be a pretty reliable diagnostic tool for obstetricians. Mine thought it was so important that my twins be monitored twice a week for that last trimester that I actually had to go in and have NSTs on Thanksgiving, Christmas and New Year’s Day. All were on a Thursday that year and my normal NST schedule was Monday/Thursday. I tried to beg off because the babies had been “good.” The OB had none of it.

So, I went to the hospital at the crack of dawn on Thanksgiving, after presents and breakfast on Christmas Day and well-rested on New Year’s Day (my 37 week pregnant self hadn’t quite made it until midnight the night before). Although I griped every time I lumbered into the office or the hospital to be strapped to those monitors for 30 minutes, it was wonderfully reassuring to hear my babies’ whooshing heartbeats and see the chart of their movements.

I felt like I really got to know them from studying their behavior twice a week. So, for as inconvenient and aggravating as they could be sometimes, the NSTs were great. Don’t be worried if your doctor tells you that you should have an NST – just enjoy the opportunity to put your feet up for a while, it won’t happen much after the baby is here!